AMA: Don't Bank on MPFS Adjustments Just Yet

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  • May 28, 2010
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Now that Medicare contractors have received updated payment files that reflect corrections in the 2010 Medicare Physician Fee Schedule (MPFS) Final Rule and health reform law provisions that are retroactive Jan. 1, 2010, physicians will want to recoup their losses by resubmitting previously processed claims. Payment changes for some services and geographic regions will be significant.
The American Medical Association (AMA), however, is recommending physicians wait to resubmit previously processed claims affected by recent changes.

With millions of 2010 claims that will require adjustments and the Centers for Medicare & Medicaid Services (CMS) unsure about how to handle the load, “These resubmissions will likely be denied as duplicate claims,” the AMA writes in its Health System Reform Insight.
Not to mention, the AMA reasons, “The new rates contained in the files do not reflect the 21.3 percent conversion factor cut that is scheduled to take effect on June 1. If Congress does not act this month, the new payment files could have a very short shelf life.”

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